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Abstract #6579 Published in IGR 3-2

Phacoemulsification and intraocular lens implantation in eyes with open-angle glaucoma

Pohjalainen T; Vesti E; Uusitalo RJ; Laatikainen L
Acta Ophthalmologica Scandinavica 2001; 79: 313-316


PURPOSE: To study the effect of phacoemulsification and intraocular lens implantation (PHACO IOL) on intraocular pressure (IOP) and glaucoma medication in open-angle glaucoma (OAG) eyes. METHODS: Thirty-eight OAG eyes with cataract underwent PHACO IOL performed by one surgeon (RJU). None of the patients had had prior intraocular surgery. Surgery was performed by scleral incision in 37% and by clear corneal incision in 63%. Patients were re-examined on the first postoperative day, after one week, four months, and in 29 cases, 1-3.7 (mean, 2.8) years after the operation. RESULTS: The mean preoperative IOP was 18.4 ± 3.3 mmHg with a mean of 1.7 glaucoma medications. On the first postoperative day, the mean IOP rose to 28.2 ± 12.5 mmHg. IOP 30 mmHg occurred in 39.5% of eyes. After one week, IOP had returned to the preoperative level. After four months, IOP had further decreased to 16.1 ± 3.8 mmHg (p = 0.0027). After a mean follow-up of 1-3.7 (mean, 2.8) years, the average postoperative IOP was 15.1 ± 2.9 mmHg, being significantly (p = 0.001) lower than the preoperative IOP, with 86% of patients having a mean of 1.6 medications on average. The type of incision (scleral versus corneal) did not affect postoperative IOP level. Using the criteria of Bigger and Becker (1971), the long-term IOP control after PHACO-IOL surgery was improved or unchanged in 86% and worse in 14% of the preoperatively well-controlled OAG eyes. CONCLUSIONS: In OAG eyes, PHACO IOL is associated with a significant decrease in IOP with less medication, up to 1-37 (mean, 2.8) years.

Dr T. Pohjalainen, Department of Ophthalmology, Helsinki University Central Hospital, Helsinki, Finland


Classification:

12.14.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.14 Combined cataract extraction and glaucoma surgery)



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